Mike Notohamiprodjo, Presenter: Nothing to Disclose

Mayo Weiss, Abstract Co-Author: Nothing to Disclose

Ruediger Baumeister, Abstract Co-Author: Nothing to Disclose

Christian Glaser MD, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Karin Anna Herrmann MD, Abstract Co-Author: Nothing to Disclose

We sought to correlate the findings in contrast-enhanced MR-Lymphangiography (MRL) with lymphoscintigraphy for detection and visualization of pathologies of the peripheral lymphatic system.

Study was conducted according to the Helsinki declaration. 20 consecutive patients with various pathologies of the peripheral lymphatic system, such as uni- or bilateral lymphedema, lymphoceles and lymph-vessel-transplants were examined with a fat-saturated T1w-3D-GRE-(FLASH)-sequence (voxel-size 0.83mm3) after intracutaneous injection of Gd-DTPA on a 3.0T-scanner (Magnetom VERIO). Four levels were examined: lower leg, knee, upper leg and pelvis. Two radiologists and a nuclear-physician evaluated depiction of lymph-collectors, diffusity of drainage, number of visualized levels and lymph-node-detection in consensus using a 3-point-scale. All examinations were correlated with corresponding lymphoscintigraphy-examinations performed with colloid-bound 99Tcm. Correlation was calculated with weighted-kappa-coefficients.

All examinations were diagnostic. Correlation between MRL and Lymphoscintigraphy was excellent (r=0.84), there were no considerable discrepancies. Normal and instant lymphatic drainage in unaffected extremities was observed in both modalities shortly after contrast application. Depiction of delayed drainage, lymph-transplants and lymphoceles was overall concordant in both modalities. Weak lymphatic-drainage in lymphoscintigraphy correlated with lymph-vessel-ectasia in MRL(9/20 cases). In 5/20 cases lymph-collectors were clearly visualized in MRL, whereas only hinted in lymphoscintigraphy. Depiction of inguinal lymph nodes was clearer in lymphoscintigraphy in 4/20 cases. In one case inhomogeneous fat-saturation hindered detection of diffuse drainage in MRL.

Correlation between MRL and Lymphoscintigraphy is excellent. Lymphoscintigraphy better visualizes inguinal lymph-nodes, whereas MRL better depicts lymph-collectors, visualizes morphological changes and provides three-dimensional anatomical information. MRL may become a valuable tool for planning and monitoring of microsurgical therapy.

Contrast enhanced MR-Lymphangiography provides highly resolved anatomical information of the peripheral lymphatic system with excellent correlation with Lymphoscintigraphy.

Notohamiprodjo, M, Weiss, M, Baumeister, R, Glaser, C, Reiser, M, Herrmann, K, Correlation of MR-Lymphangiography at 3T with Lymphoscintigraphy.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8007588.html